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Covid incidence: Can we have greater objectivity, please?

Let’s leave partisan politicking aside for now and focus on navigating safely through the Covid-induced health and economic storm

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Frankly, I am getting a little tired of the lack of objectivity in the discussions of the Covid pandemic in Malaysia.

For those who persist in calling the Perikatan Nasional government a “backdoor government”, every bit of information is presented in a way to support the notion that the coalition is totally incompetent.

For example, a chart was circulated on social media a few days ago showing that Malaysia’s daily rate of new cases per million population was the highest in the world, with an accompanying comment about the ineptness of the PN administration.

The pandemic is following a waxing and waning pattern across the world. There are waves of infections occurring on and off in various countries.

While the case incidence figures in the chart above are correct, they are not sufficient basis to give a balanced evaluation of the Malaysian government’s handling of the pandemic so far.

Let me share with you some figures that give a far better basis to evaluate Malaysia’s performance.

Covid-19 incidence and mortality per million population in selected countries (until 21 May 2021)
  Country  Covid cases
per million population
  Deaths due to Covid
per million population
fatality rate
  USA  101,873  1,816  1.78%
  Brazil  75,190  2,100  2.79%
  Italy  69,427  2,074  2.99%
  UK  65,429  1,873  2.86%
  India  19,218  218  1.13%
  Malaysia  15,842  71  0.45%
  Singapore  10,500  5  0.05%
  Philippines  10,685  180  1.68%
  Indonesia  6,451  179  2.77%
  Source: worldometer.info/coronavirus 21/5/2021

Statistics need to be interpreted cautiously. I would argue that the incidence of Covid cases per million population gives the best single measure of a country’s competence in handling the pandemic.

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Early case detection, proper contact screening, testing and isolation of positive cases is what keeps the incidence levels down. These interventions require a high level of political commitment and coordination, which clearly was lacking in some of the richest countries in the world!

Of course, the caveat would be that the percentage of asymptomatic or mildly symptomatic cases recognised as Covid positive would vary depending on how widely the screening net is cast for each positive case. And the lower incidence rates in some developing countries could be due to under-diagnosis.

The case fatality rate is more difficult to fathom as mortality depends on several factors. It is probable that the higher case fatality rate in Indonesia compared to Malaysia is due to them not diagnosing as many of the asymptomatic cases as we are doing in Malaysia, ie our case fatality rate is lower partly because our denominator for this index is larger. Another possibility is that in Indonesia, adequate medical care was not available for some of the 15% of cases who required oxygen support. 

The much higher case fatality rate for Italy and the UK is because the people in these countries have a greater propensity to over-reaction of the immune system to Covid infection. This over-reaction precipitates ‘cytokine storms’ and derangement of the clotting mechanism in the body. This sets in during the second week of clinical illness, and the damage done then is no longer due to the coronavirus but to ‘collateral damage’ caused by an overexcited immune system. (This is why the mainstay of treatment for these patients are steroids to calm down the immune system and anticoagulants to prevent abnormal clotting.)  

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Based on the table above, the government hasn’t done too badly in handling the pandemic, though obviously, mistakes have occurred: the Sabah election, the failure to win the trust and cooperation of migrant workers, and the failure to guard against overcrowding in our bazaars and markets.

We citizens have a right, even a duty, to criticise and offer ideas how to improve the handling of Covid. But our criticism must be dispassionate and based on objective reasoning, and not consist of ‘cheap shots’ to score partisan political points.

We (in Malaysia and in the world) are now facing the biggest crisis faced by humankind since World War Two. We need our government to do the right thing to steer us out of this combined health and economic crisis.

The government has to:

  • Implement movement restrictions as and when required to keep the incidence of new cases below the threshold that would overwhelm the capacity of our hospitals
  • Ensure that the vaccination programme reaches 80% of our population (26 million) as soon as possible. To date, only 11 million Malaysians have signed up. The rest remain unconvinced, and the anti-vaxxers are not helping the situation
  • Ensure that those whose incomes have collapsed because of the lockdowns are identified and supported
  • Raise the funds necessary to do all the above without compromising Malaysia’s credit ratings in the financial markets

The government needs the support and trust of the people to carry out the above measures. Running the government down and undermining its credibility does not help in handling the Covid nightmare. Do criticise if there are shortcomings and, if possible, suggest pragmatic measures to overcome these.

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But disparaging everything the government is doing on the basis that it is an “illegitimate backdoor government” – and therefore everything it does must be faulty – does not help the situation!

Let’s leave partisan politicking aside for now and focus on navigating safely through the Covid-induced health and economic storm.

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